Impulsivity across Substance Use Categories: Consideration of Sex/Gender

Purpose of Review: The goal was to review recent (1/2015–2/2020) evidence of impulsivity as a feature of substance use disorders or use of substances (alcohol, cannabis, nicotine, opioids, stimulants) in males compared with females in terms of the following: (a) impulsivity in substance-using groups (or substance-using compared with control groups), and (b) relationship between impulsivity and substance use behavior, clinical severity, or treatment outcomes. Recent Findings: Of 361 papers identified by the searches, 69 met inclusion criteria, and 39 were highlighted for considering sex/gender in relation to impulsivity in substance-using populations. Taken together, findings supported higher impulsivity in males and females who use substances, relative to controls; and higher impulsivity was linked with more substance use/severity in both sex/genders. There were mixed findings regarding male versus female differences in impulsivity among individuals who use substances, or in the magnitude of the relationship between impulsivity and substance use severity. Summary: The current body of evidence does not point to a consistent sex/gender difference in the role of impulsivity within and across substance use disorders. Impulsivity is a clinically relevant construct for male and female individuals who use substances, across a range of substances.